Tuesday, January 25, 2011

Euthanasia and Organ Donation in Belgium

Michael Cook has written an interesting article about euthanasia and organ donation in Belgium. Several years ago I reported on a study that was done in Belgium where a woman who was going to die by euthanasia also consented to donate her organs.

It is interesting how the earliest cases of an unethical act are often done in controversial circumstances. The Belgium woman who died by euthanasia and then had her organs removed was a woman in locked-in syndrome. She was a cognitively disabled woman who died by euthanasia and then had her organs removed.
The concern about organ donation after euthansia in Belgium is made greater by the fact that Belgium presumes consent for Organ donation. The health of organs is often related to the health of the donor, making the prospect of waiting for consent before euthanasia in question. Organ donor rules in Belgium.
It should not surprise us that a recent study of euthanasia in the Flanders region of Belgium showed that 32% of euthanasia deaths were done without explicit request or consent.Michael Cook wrote in his recent article:

A group of Belgian doctors are harvesting “high quality” organs from patients who have been euthanized. This is not a secret project, but one which they described openly at a conference organised by the Belgian Royal Medical Academy in December.In a PowerPoint presentation, Dirk Ysebaert, Dirk Van Raemdonck, Michel Meurisse, of the University Hospitals Of Antwerp, Leuven And Liège, showed that about 20% of the 705 people who died through euthanasia (officially) in 2008 were suffering from neuromuscular disorders whose organs are relatively high quality for transplanting to other patients. This represents a useful pool of organs which could help to remedy a shortage of organs in Belgium (as everywhere else).
It is not clear from the presentation how many patients participated in their scheme. However, in a 2008 report, Belgian doctors explained that three patients had been euthanased between 2005 and 2007 and had agreed to donate their organs.
Euthanasia for organ transplant is a bit different from normal euthanasia, the doctors say, because they prefer that patients die in hospital rather than at home.
They have developed a protocol for the procedure.

There has to be a strict separation between the euthanasia request, the euthanasia procedure, and the organ procurement.

The donor and his (or her) relatives have to consent.

The euthanasia is performed by a neurologist or psychiatrist and two house physicians.

Organ retrieval begins after clinical diagnosis of death by the three physicians.

And, of course, staff participation is voluntary.

It sounds very similar to the Groningen Protocol, the Protocol that allows Dutch physicians to euthanize newborns with disabilities.

How much pressure to convince people to die by euthanasia will be on people. First there is pressure based on the cost of medical care. Then there is pressure from family members who are tired of caring for the person. Then there is pressure on a person because society has made them feel like a burden. Now there is pressure because good will come from euthanasia if they donate their healthy organs.